title: Tumour-associated macrophages might represent a favourable prognostic indicator in patients with papillary renal cell carcinoma.
abstract: OBJECTIVE
  Tumour-associated macrophages (TAM) have been reported to be regulators of progression in various human cancers. We evaluated the prognostic relevance of TAM in a large series of patients with papillary renal cell carcinoma (PRCC).
  
  
  RESULTS
  The impact of TAM on cancer-specific survival (CSS) in 177 patients with PRCC was assessed using the Kaplan-Meier method and log-rank test. A multivariate Cox regression analysis was performed with respect to CSS. The presence of TAM was noted in 112 of 177 (63%) tumours and was associated statistically significantly with favourable pathological parameters, including low pathological T stage, node-negative tumours, low tumour grade, absence of vascular invasion and papillary subtype (all P < 0.05), respectively. Five-year CSS probabilities for patients with TAM-positive tumours were 93.5%, compared with 72.5% in patients with TAM-negative tumours, respectively (P < 0.001). Multivariate analysis revealed node-positive tumours, distant metastases and UICC stage (I versus II-IV) as independent predictors of death from PRCC, whereas the presence of TAM was associated independently with favourable outcome (hazard ratio = 0.45, 95% confidence interval 0.24-0.84, P = 0.012).
  
  
  CONCLUSIONS
  The presence of TAM was shown independently to reduce the risk of death from cancer by 55%. The presence of TAM should therefore become part of routine pathology reporting in PRCC.
authors.affiliation: Department of Urology, Medical University of Graz, Graz, Austria.
authors.forename: Georg C
authors.initials: GC
authors.lastname: Hutterer
authors.forename: Martin
authors.initials: M
authors.lastname: Pichler
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Chromecki
authors.forename: Karin A
authors.initials: KA
authors.lastname: Strini
authors.forename: Tobias
authors.initials: T
authors.lastname: Klatte
authors.forename: Karl
authors.initials: K
authors.lastname: Pummer
authors.forename: Mesut
authors.initials: M
authors.lastname: Remzi
authors.forename: Sebastian
authors.initials: S
authors.lastname: Mannweiler
authors.forename: Richard
authors.initials: R
authors.lastname: Zigeuner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000473:pathology* / Q000556:secondary; D015331:Cohort Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology*; D008264:Macrophages / Q000276:immunology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D055815:Young Adult
keywords: macrophages; papillary renal cell carcinoma; prognosis